Association of cardiac injury with hypertension in hospitalized patients with COVID-19 in China

Abstract Outbreak of global pandemic Coronavirus disease 2019 (COVID-19) has so far caused countless morbidity and mortality. However, a detailed report on the impact of COVID-19 on hypertension (HTN) and ensuing cardiac injury is unknown. Herein, we have evaluated the association between HTN and ca...

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Main Authors: Xiaofang Zeng, Anandharajan Rathinasabapathy, Dongliang Liu, Lihuang Zha, Xiangwei Liu, Yiyang Tang, Famei Li, Wenchao Lin, Zaixin Yu, Huiling Chen
Format: Article
Language:English
Published: Nature Portfolio 2021-11-01
Series:Scientific Reports
Online Access:https://doi.org/10.1038/s41598-021-01796-0
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author Xiaofang Zeng
Anandharajan Rathinasabapathy
Dongliang Liu
Lihuang Zha
Xiangwei Liu
Yiyang Tang
Famei Li
Wenchao Lin
Zaixin Yu
Huiling Chen
author_facet Xiaofang Zeng
Anandharajan Rathinasabapathy
Dongliang Liu
Lihuang Zha
Xiangwei Liu
Yiyang Tang
Famei Li
Wenchao Lin
Zaixin Yu
Huiling Chen
author_sort Xiaofang Zeng
collection DOAJ
description Abstract Outbreak of global pandemic Coronavirus disease 2019 (COVID-19) has so far caused countless morbidity and mortality. However, a detailed report on the impact of COVID-19 on hypertension (HTN) and ensuing cardiac injury is unknown. Herein, we have evaluated the association between HTN and cardiac injury in 388 COVID-19 (47.5 ± 15.2 years) including 75 HTN and 313 normotension. Demographic data, cardiac injury markers, other laboratory findings, and comorbidity details were collected and analyzed. Compared to patients without HTN, hypertensive-COVID-19 patients were older, exhibited higher C-reactive protein (CRP), erythrocyte sedimentation rate, and comorbidities such as diabetes, coronary heart disease, cerebrovascular disease and chronic kidney disease. Further, these hypertensive-COVID-19 patients presented more severe disease with longer hospitalization time, and a concomitant higher rate of bilateral pneumonia, electrolyte disorder, hypoproteinemia and acute respiratory distress syndrome. In addition, cardiac injury markers such as creatine kinase (CK), myoglobin, lactic dehydrogenase (LDH), and N-terminal pro brain natriuretic peptide were significantly increased in these patients. Correlation analysis revealed that systolic blood pressure correlated significantly with the levels of CK, and LDH. Further, HTN was associated with increased LDH and CK-MB in COVID- 19 after adjusting essential variables. We also noticed that patients with elevated either high sensitivity-CRP or CRP demonstrated a significant high level of LDH along with a moderate increase in CK (p = 0.07) and CK-MB (p = 0.09). Our investigation suggested that hypertensive patients presented higher risk of cardiac injury and severe disease phenotype in COVID-19, effectively control blood pressure in HTN patients might improve the prognosis of COVID-19 patients.
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spelling doaj.art-66d926e2e8be433ca6f3bcfd9c36130c2022-12-21T23:13:49ZengNature PortfolioScientific Reports2045-23222021-11-0111111010.1038/s41598-021-01796-0Association of cardiac injury with hypertension in hospitalized patients with COVID-19 in ChinaXiaofang Zeng0Anandharajan Rathinasabapathy1Dongliang Liu2Lihuang Zha3Xiangwei Liu4Yiyang Tang5Famei Li6Wenchao Lin7Zaixin Yu8Huiling Chen9Department of Cardiology, Xiangya Hospital, Central South UniversityDivision of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical CenterDepartment of Spine Surgery, Xiangya Hospital, Central South UniversityDepartment of Cardiology, Xiangya Hospital, Central South UniversityDepartment of Cardiology, Xiangya Hospital, Central South UniversityDepartment of Cardiology, Xiangya Hospital, Central South UniversityDepartment of Cardiology, Xiangya Hospital, Central South UniversityDepartment of Cardiology, Xiangya Hospital, Central South UniversityDepartment of Cardiology, Xiangya Hospital, Central South UniversityDepartment of Geriatric, Xiangya Hospital, Central South UniversityAbstract Outbreak of global pandemic Coronavirus disease 2019 (COVID-19) has so far caused countless morbidity and mortality. However, a detailed report on the impact of COVID-19 on hypertension (HTN) and ensuing cardiac injury is unknown. Herein, we have evaluated the association between HTN and cardiac injury in 388 COVID-19 (47.5 ± 15.2 years) including 75 HTN and 313 normotension. Demographic data, cardiac injury markers, other laboratory findings, and comorbidity details were collected and analyzed. Compared to patients without HTN, hypertensive-COVID-19 patients were older, exhibited higher C-reactive protein (CRP), erythrocyte sedimentation rate, and comorbidities such as diabetes, coronary heart disease, cerebrovascular disease and chronic kidney disease. Further, these hypertensive-COVID-19 patients presented more severe disease with longer hospitalization time, and a concomitant higher rate of bilateral pneumonia, electrolyte disorder, hypoproteinemia and acute respiratory distress syndrome. In addition, cardiac injury markers such as creatine kinase (CK), myoglobin, lactic dehydrogenase (LDH), and N-terminal pro brain natriuretic peptide were significantly increased in these patients. Correlation analysis revealed that systolic blood pressure correlated significantly with the levels of CK, and LDH. Further, HTN was associated with increased LDH and CK-MB in COVID- 19 after adjusting essential variables. We also noticed that patients with elevated either high sensitivity-CRP or CRP demonstrated a significant high level of LDH along with a moderate increase in CK (p = 0.07) and CK-MB (p = 0.09). Our investigation suggested that hypertensive patients presented higher risk of cardiac injury and severe disease phenotype in COVID-19, effectively control blood pressure in HTN patients might improve the prognosis of COVID-19 patients.https://doi.org/10.1038/s41598-021-01796-0
spellingShingle Xiaofang Zeng
Anandharajan Rathinasabapathy
Dongliang Liu
Lihuang Zha
Xiangwei Liu
Yiyang Tang
Famei Li
Wenchao Lin
Zaixin Yu
Huiling Chen
Association of cardiac injury with hypertension in hospitalized patients with COVID-19 in China
Scientific Reports
title Association of cardiac injury with hypertension in hospitalized patients with COVID-19 in China
title_full Association of cardiac injury with hypertension in hospitalized patients with COVID-19 in China
title_fullStr Association of cardiac injury with hypertension in hospitalized patients with COVID-19 in China
title_full_unstemmed Association of cardiac injury with hypertension in hospitalized patients with COVID-19 in China
title_short Association of cardiac injury with hypertension in hospitalized patients with COVID-19 in China
title_sort association of cardiac injury with hypertension in hospitalized patients with covid 19 in china
url https://doi.org/10.1038/s41598-021-01796-0
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